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The new Medicines Act, which Spain's cabinetl of ministers approved on Tuesday 8 April and which is now beginning its parliamentary procedure, will allow nurses and physiotherapists, to prescribe a wider range of medicines.
Nurses have been calling for greater powers to be able to prescribe certain medication since 2010 and they were extended in 2015 with the approval of a royal decree that empowered the Government to regulate "the indication, use and authorisation of dispensing certain medicines subject to medical prescription by nurses, within the framework of the principles of integrated health care and for the continuity of care, through the application of protocols and clinical and care practice guidelines". However, it took another five years for the first guide to be published.
So far, the Ministry of Health has drafted nine guidelines that have enabled nurses to prescribe medicines for different health problems.
The first guideline was approved in October 2020 and allowed nurses to prescribe medicines for injuries including heparin, hydrocortisone and silver nitrate.
The second guideline was published almost two years later, on 30 June 2022, and authorised nurses to prescribe drugs for high blood pressure, type one and type two diabetes which included insulins, metaformin and glucagon.
Just a few days later, on 8 July, the Ministry of Health approved guidelines for burns, allowing nurses to prescribe silver sulphadiazine, betamethasone, fluocinonide or hydrocortisone aceponate.
In December of that year, the fourth guideline empowered nurses to prescribe medications for ostomies, which are artificial openings in the abdominal wall that are surgically created to allow the passage of faeces and urine. This protocol authorised them to prescribe lactulose, topical clotrimazole, topical miconazole or silver nitrate.
The next prescription extension took place in June 2023 with oral medication to prevent blood clots, for which acenocoumarol, warfarin and phytomenadione were allowed to be prescribed.
On 26 October 2023, a further guideline was published, allowing the prescription of two of the most popular medicines: paracetamol and ibuprofen.
The seventh guideline was published on 22 March 2024 for diagnostic or therapeutic procedures requiring the use of local anaesthetics. This group included the possibility of prescribing bupivacaine, lidocaine, mepivacaine or tetracaine.
On the same day, another protocol was approved and they were allowed to prescribe the anti-smoking drugs varenicline and cytisinicline.
And finally, the ninth guideline, the last one published, dated 9 August 2024, allowed the dispensing of drugs such as fosfomycin tromethamol and nitrofurantoin for uncomplicated lower urinary tract infection in adult women.
"When the new law is finally passed, the entire health system will benefit, starting with patients, who will see improved accessibility to the health system, which will result in an improvement in the quality of care. They will go to their nurse for any treatment, for the monitoring of their chronic treatment and they will obtain the medication they need without having to go to another professional for the prescription, which will also avoid unnecessary visits," said the president of the Spain's general nursing council, Florentino Pérez Raya.
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